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  White House Calls Affordable Care Act Replacement a Work in Progress  CSPAN  March 7, 2017 3:41pm-4:13pm EST

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stakes. host: william galston from brookings today's white house today's white house briefing tom price spoke to reporters about the congressional republican plan to repeal the affordable care act. his is about half an hour. > i brought a guest. good afternoon.
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first off at the top, i want to acknowledge that there's been an additional wave of threats to jewish committee centers and anti-defamation league offices. according to some reports there have been over 100 bomb threats phoned into jewish institutions since the start of this year alone. as the president said at the beginning of his joint address, quote, we're a country that stands united in condemning hate and evil in all of its forms. we denounce these latest anti-semitic and hateful threats in the strongest terms. it is incredibly saddening i have to continue to share these disturbing reports with you and i share the president's thoughts that he hopes we don't continue to have to share these reports with you. as long as they will -- as long as they do continue we will continue to condemn them and look at ways which we can stop them. now onto news of the day, you saw president trump yesterday continue to deliver on two of his most significant campaign promises -- protecting the country against radical islamic terrorism and repeal and
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replacing obamacare with a patient-centric alternative. we talked a lot about the executive order protecting the nation from foreign terrorists he wanting the united states yesterday, and so onto obamacare, i'd like to introduce the secretary of health and human services, dr. tom price, to come up and talk to you a little bit about the plan to repeal and replace obamacare. dr. price. secretary price: thanks, sean. good afternoon. first, let me just share with you what an honor it is to serve as secretary of health and human services. i'm the third physician out of 23 individuals that had the privilege of serving as the secretary of health and human services. and the mission at our department is to improve the health and safety and well-being of the american people and we take that mission very, very seriously. and for many americans right gain eir ability to health care or health coverage is a real challenge. for most americans they receive
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their health coverage through their employer. it's about 175 million folks. those individuals will see no significant change other than there won't be a penalty for not purchasing coverage. for the folks in the medicare system, there will be no changes at all. in the current in the law. but we're talking about those people in the individual and small group market, the moms and pops, the folks who run the corner grocery store, the corner cleaners, those individuals out there are having huge challenges gaining care and gaining coverage. medicaid is a program that by and large has decreased the ability for folks to gain access to care, and we want to make certain we address that. this is about patients. this is not about money. this is not about something else. this is about patients. and sadly the costs are going up for those folks in the individual and small group market, the access is going down. premiums increased 25% over the last year on average. arizona had an increase of 116%. deductibles are going up for many, many folks.
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if you're mom or dad out there and you make $40,000, $50,000, $60,000 your deductible in that individual and small group market oftentimes is $8,000, $10,000, $12,000 a year. what that means is you have an insurance card but you can't get care because you can't afford the deductible and we know this is happening when we talk to folks trying to provide the care. 1/3 of the counties in the united states have only one insurer offering coverage on the exchange. five states only have one insurer often coverage. one insurer is not a choice, so we need to make certain we correct that. in tennessee it was announced there are counties that have no insurer offering coverage on the exchange. insurers are leaving the market on the exchange. last year there were 232 insurers offering coverage on the exchange. now it's 167. that's a loss of about 130%. all of this means patients are
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not getting the care that they need. now, the principals that we have our guiding star are affordability. we want a system that's affordable for everybody. accessibility. we need a system that's accessible for everybody. a system of the highest quality. a system that incentivizes innovation in the health care system and a system that empowers patients through both transparency and accountability. the president spoke last week, last tuesday to a joint session of congress and he laid out to his principles. first, wanted to make certain those with pre-existing illness and injury were not priced out of the market. nobody ought to lose their coverage because they get a bad diagnosis. in terms of affordability, health savings accounts growing choices for patients is incredibly important. tax credits that allow individuals to be able to purchase the kind of coverage that they want, not that the government forces them to buy. we've always talked about in terms of what kinds of reforms need to be put in place that we ed to equalize the tax
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treatment for the purchase of coverage. those, again, in the employer-sponsored market, they get a tax benefit for buying health coverage. those folks that are out there in the individual and small group market, no tax benefit, and that's what this plan would do. state flexibility. it's incredibly important we allow the states to be the ones defining what health coverage is, have the flexibility, especially in the medicaid program to be able to respond to their vulnerable population. lawsuit abuse, the president mentioned and it's incredibly important, it wastes billions and billions of dollars every single year and we need to make certain we are addressing that as well. the president also talked about a guide path, an appropriate transition to this new phase for health care for our country and that's important as well, so that nobody falls through the cracks. buying across state lines, buying insurance across state lines, the president talked about this on the campaign over and over. the american people understand the commonsense nature of purchasing across state lines and it increases competition and we need to make certain
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that happens and then addressing the incredible increase in drug prices. there are three phases of this plan. one is the bill that was introduced last evening in the house of representatives, the start of all of this. second are all the regulatory modifications and changes that can be put into place. as you all well know the previous administration used regulations fairly well. in fact there were 192 specific rules that were put out as it relates to obamacare. over 5,000 letters of guidance and the like, and we are going to go through every single one of those and make certain if they help patients then we need to continue them. if they harm patients or increase costs, then obviously they need to be addressed. and then there's other legislation that will need to be address that had can't be done through the reconciliation process. so the goal of all this is patient-centered health care. where patients and centers and doctors are making medical decisions and not the federal government. the mend the house for
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introduction of the bill yesterday and we look forward to working with all individuals in this process and i look forward to a few questions. yes, sir. reporter: your time in the house with the conservative groups like heritage action have with rank and file members. what does it say about this legislation that they are out with opposition to it? secretary price: this is the beginning of the process and we look forward to working with them and others to make certain that, again, we come up with that process that aligns with the principles that we defined, that they actually adhere to or agree with as well and that is we need a system that's affordable for folks, a system that's accessible for individuals, that's of the highest quality, that incentivizes innovation and empowers patients. and so we look forward to working with them through this process. reporter: secretary, congressman johnson said americans will forgo a new iphone to pay for health care and they have to make these choices. does the administration agree with that? will americans under this plan, will they need to maybe
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sacrifice other goods to pay for their health care? secretary price: this is an important question because right now the american people are having to sacrifice in order to purchase coverage and as i mentioned, many individuals can't afford the kind of coverage that they have right now. so they got that insurance card but they don't have care. what our desire is to drive down the health care costs for everybody, and the way you do that is to increase choices for folks, increase competition, return the regulation of health care where it ought to be which is at the state level, not at the federal level. all of these things that taken in their aggregate will in fact decrease the cost of health care and health coverage and that will allow folks to be able to purchase the coverage that they want. yes, sir. reporter: thank you, dr. price. i have two questions for you. first has to do with guarantees you can make as administration's point person on this legislation. can you guarantee whatever legislation emerges and makes it to the president's desk will allow individuals if they like their doctor they can keep
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their doctor and the second guarantee is, can you also guarantee that health care premiums for individuals will come down with this new legislation? secretary price: again, a remarkably important question. the promise from the last administration, if you like your doctor you can keep your doctor, if you like your plan, you can keep your plan, both those were not true. we think it's incredibly important for the american people to select the physician and the place where they're treated themselves, that the government ought not be nvolved in that process. and so our goal is to absolutely to make certain that individuals have the opportunity to select their physician. in terms of premiums, we believe strongly that through this whole process and as it takes effect that we'll see a decrease in not only the premiums that individuals will see but a decrease in the cost of health care for folks. remember, with another promise that the previous administration made, that you'd see a decrease in $2,500 on average for families across
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this land. in fact, they have seen an increase of $,500 or $3,000. we will empower patients and hold down costs. reporter: mr. secretary, you are quite a distance away from conservatives with this plan. the central part of it which is tax credits which they see is yet another entitlement very similar to the entitlement of obamacare but different in form. how do you convince them since it will take tax credits to make this work that they need to swallow this and move forward with the bill? you have had an awful lot of opposition over the central tenant? secretary price: it's all about patients. in order to make it so nobody falls through the cracks, we need to have a system for individuals to have the coverage they want. we as conservatives and others have said for a long, long time we believe it's important to equalize the tax treatment for those purchasing coverage, gaining coverage through their employer and those not.
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and the tax credit is the opportunity to be able to equalize that tax treatment. folks talked about this for many years, actually, so there's not a distortion in the tax code for who's able to gain a benefit for being able to purchase coverage and not. reporter: mr. secretary, you were talking about making sure people don't fall through the cracks. the last administration with obamacare focused on making sure the underserved were part of the equation. what is the safety net or safeguard you have to make sure to ensure people don't fall through the cracks beyond the tax incentives but also for the underserved who are now part of -- many are part of the program that worked before? secretary price: this is extremely important as well. the current system, as you likely know, for those vulnerable in our population, especially in the medicaid population, this is a system that's broken. you got a third of the physicians in this country, one-third of the doctors in this country that would be
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eligible to see medicaid patients who aren't seeing medicaid patients right now. because they forgot to take care of patients. it's because it's too onerous or too difficult to see medicaid patients. we want states to have the flexibility to fashion the program for their vulnerable population that actually responds to that population that gives them the authority, them the choices, them the opportunity to gain coverage and the care they believe most appropriate. reporter: is there some type of punishment or some type of something to put in place that happens, they follow through on their intent? secretary price: absolutely. there's accountability throughout the plan that we have that would allow for the secretary and the department to be certain that the individuals that we believe need to be cared for are being cared for in the state at the appropriate level. but we believe this is a partnership. this is about patients and partnerships. the previous administration tended to make it about
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government. we believe it's about patients and partnership and we want to partner with every single person in this land who wants to make certain we allow the kind of choices and quality to exist. yes. reporter: the president tweeted earlier today, he said our wonderful new health care bill. does this represent the administration's bill? is there anything in this bill that the administration cannot support? secretary price: this has been a work in progress. as you know this has been going on for over a year, the work i had the privilege of participating in when i served in the house of representatives in the last congress was open and transparent and we invited folks in to give their ideas. tens if not hundreds of people had input into that process. this grew out of that and over the past number of weeks we've been having conversations with folks on the hill, in the house and in the senate and other stakeholders and so this is a work product that's the result of all of that process.
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the president and the administration support this step in the right -- what we believe is in the right direction, a step that repeals obamacare and guess us moving in the direction of those principles that i outlined. reporter: do you support everything that's in that bill on the table? do you support everything in the bill that's sitting on the table, sir? secretary price: this is a work in progress. as you know it's a legislative process that occurs. i'm glad you pointed out the bills on the table there. as you'll see this bill right here was the bill that was introduced in 2009 and 2010 by the previous administration. notice how thick that is. some of you recall i turned the pages and went through that piece of legislation in a youtube. the pile on the right is the current bill. and what it means is that we are making certain that the process, that the decisions that are going to be made are not going to be made by the federal government. they are going to be made by patients and families and doctors. one last. reporter: given the opposition,
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does this plan need to be salvaged in your view and how do you do it? secretary price: you know what's happens with these things. you start at a starting point, people engage and they get involved in the process sometimes to a greater degree. nothing focuses the mind than a bill that's currently on the table and is a work in process and we'll work through it. this is an important process to be had. the american people have said to their elected leaders, the obamacare process for them gaining coverage and care is not working. that's what they've said, and so we believe it's important to respond to the american people and provide a health care system that allows for them to purchase the kind of coverage and care that they desire. reporter: you said in your letter to the house chairman that necessary and technical and appropriate changes need to be made for the bill to reach
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the president's desk. so what specific changes is the white house and the administration looking for in this bill? secretary price: as i mentioned, there are three different phases to this process. one is this bill, this legislation that's working through. under the rules of reconciliation, which is a fancy term to mean there are only certain things you can do from a budgetary standpoint has to affect either spending or revenue. there are things you can't do in this bill and those we plan on doing across the horizon in phase two which is the regulatory portion and then in phase three which is another piece of legislation that would be going through the house and the senate with a supermajority in the senate. that process will incorporate all of the kinds of things that we believe are absolutely necessary to reconstitute that individual and small group market and to get us in position, again, where patients and families and docs are making these decisions. reporter: can you guarantee this plan will not have a
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negative impact of americans losing health insurance? secretary price: the goal and the desire of those on the hill is this does not increase the ost to the federal government. reporter: i have questions about how they control costs and how they have [inaudible] the medicaid per capita block grant to states, how is that sort of fundamentally different from the obamacare regime on medicaid in terms of access? the second point, why doesn't this bill do away with the cost sharing community ratings version that obamacare had? secretary price: to the per capita cap. medicaid is a system that doesn't work for patients. they need to see particular physicians who aren't able to see them. all americans should be saddened by the situation that we have when there are patients out there that can't get the care that they need.
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we believe one of the keys to providing appropriate care in the medicaid population is allowing the states to have the flexibility to address that medicaid population. remember, medicaid population four different demographic groups. those who are it's those who are disabled, those who are moms. we the federal government force states, mostly, to take care of those individuals in exactly the same way. if you describe that to the folks back home on main street, they say, that doesn't make sense at all. you need a program that's different for healthy moms and kids that's different than folk whors disable and seniors. what -- disable. at we believe is appropriate is to say to the states, you know how best to care for your people, we're going to watch you but you know how to do so.
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we are wasting significant amount os money. not that folks are getting too much care but there's significant abuse of the system. in terms of cost share, i think the cost sharing measures are being addressed. it's important we run through that process. this is the process where we felt the previous administration was spending money that they didn't have the authority to spend and congress is working through that to make certain that the rightful holders of the authority to spend money in this nation which is the congress of the united states exercises that authority. >> mr. speaker, how does the white house and you feel about the label trump care? secretary price: i'll let everies talk about the labels. i prefer patient care. this isn't about politicians or insurance companies, this is about patients. patients in this nation, especially those in the individual and small group market, these are the folks. i had the privilege of going to cincinnati last week with the vice president to a small business round table. one of the business owners, one
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of the small business owners there said he had 18 employees last year at this time. this year he has 15 employees. not because he doesn't have the work but because of the cost of health coverage for those individuals forced him, forced him to let three people go. now, they're being forced to let three people go because the federal government has put in place rules and regulations that make it virtually impossible for folks in the individual and small group market to put in place coverage for their employees. this is a system that's not working for people. if we focus on patient, i'll call it patient care if you focus on patients we'll get to the right answer. >> a major complaint of conservatives with phase one of the obamacare repeal and replace is that it is missing a measure that would allow health care to be sold across state lines. the president said this morning that that would be in either phase two or phase three. is that something that you believe the president could to through executive action and
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then you yourself could do? or is that something that you believe has to be addressed legislatively? secretary price: there are different aspects to the purchase across state lines that will allow individuals to gain the kind of choices they want. some of this might be able to be done from a regulatory or rules standpoint. some of it will require legislation. and that's where we're going to need the assistance of our friends on the other side of the aisle. the american people have demanded that they be able to purchase coverage across state lines, purchase coverage they they want for themselves. whether it's through association health plans which allows individuals who are in small business groups like the fell i just mentioned to pool together nationally or whether it's mom and dad who don't gain coverage through their employer through something called individual health pools that allows folks to pool together solely for the purpose of purchasing coverage even though they're not otherwise economically aligned. that allows people -- there are 18 million people in the
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individual and small group market. that would allow those individuals to purchase coverage and get the purchasing power of millions. haas thuge -- that's huge power and authority that we want to put in the hands of people and put in the hands of patients. some of that may require legislation. >> mr. speaker, thank you. two question -- mr. secretary. thank you. first, congressman john katko of new york said the issue of denying federal funds to planned parenthood should be separate from whatever health care bill emerges from congress and is signed into law by the president. is that the administration's position as well? my second question is this. you mentioned earlier the people who had their health care plans canceled when they thought they cowl keep it. i believe in your state of georgia, more than a million people had that experience. will some of the plans that were canceled be able to come back under the new health care plan?
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secretary price: in terms of planned parenthood, we think it's important that the legislature work its will on this process. it's incredibly important that we not violate anybody's conscience. we want to protect the conscience provisions that exist. it's also important to appreciate that through community health centers, the bill that's being proposed right now would allow greater access for women to health care in greater numbers of facility across this land and they've actually proposed more money for women's health care than currently exists. so i think that they're working their best to address that issue. in terms of whether or not old plans that were available before might be available, absolutely. we believe that the opportunity to provide a robust market robust choices for individuals across this land, will be secure. that's one of the key of bringing down the premium costs and bringing down costs. we're excited about that coming to pass.
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>> if the new plan calls for repealing the revenue generating taxes and penalties but for keeping the entitlements, how is that sustainable? secretary price: that's the budget office score, once congress receives that score they'll be working through that to make sure that it is fiscally responsible. imagine if you would, however, a system where we're -- where the insentives within the system are all to drive down costs to provide greater choices and competition for folks and respond to the specific needs of patients and in so doing what you actually do is get a much more efficient system for the provision and delivery of health care. it's a system we don't have right now because the previous administration felt that the government, federal government ought to do all of this we've seen what came about when the federal government does all of that. that is, increasing premiums, increasing deductibles, decreasing choices. you've got a card that says you've got insurance but you walk in and can't afford what it
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is for the doctor that's trying to take care of you. this is not a system that's working for folks in that individual small group market and in the exchanges. >> many complain that obamacare resulted in higher wait time in emergency rooms. will this new bill cause that? do you have any idea on that? secretary price: one of the things the previous administration said is they would be able to drive folks away from one of the most expensive areas for the provision of health care, that is the emergency rooms. in fact they did just the opposite. much of that is because of the rules and regulations they put in place. so from our perfect i, we believe that if you -- if individuals are able to purchase the kind of coverage that they want, they'll have access to the kind of doctors and other providers that they desire and won't need to be able to be seen in the emergency room. they'll already have that -- already have that care. emergency rooms ought to be for emergencies, not for the standard care that individuals tend to receive right now. so we believe that if you put in place the right system, then
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emergency rooms and emergency physicians will be able to have the opportunity to care for those individuals that appropriately present to their department. >> i'm interested in following up on your comment that it's important that no one vote on anything that violates their conscience. federal funding already can't be used for abortions. are you saying the administration has a position on birth control at community health centers? and is the administration looking to actively withhold funding to planned parenthood if they continue to provide abortions as has been reported? secretary price: we're working through all those issues. many of those were through the rule making process and we're working through that. that's not a part of this piece of legislation. >> what about the provision of birth control and access to it, on women health care you said you want to expand. secretary price: we're working through rules and regulations to see where the previous administration was, how they did it and whether or not it needs
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to be addressed with the understanding that what we believe is important is to define whether or not that rule or regulation helps patients or -- and decreases costs or harms patients and increases costs. if it does the latter, then we need to do away wit. if it does the former. >> >> isn't subpoena the con shones, what were the issue of conscience you were talking about then? secretary price: to make sure individuals in market are not forced to do things that violate their conscience. >> small businesses have been waiting for new bill under president trump. any message for them? secretary price: i think that this is the culmination of years of work. it's the culmination of years of concern and frustration by the american people. they knew at the time that the previous bill -- previous law passed that it wasn't going to help them. they knew that that costs were
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going to go up. in fact, we predicted at the time that costs would go up and that access would go down. so this is the culmination of years of hard work by the electorate, by the citizens of this country, to say that we want a -- we want a system again that respects patients and families and doctors in these decisions. >> thank you, mr. secretary. the president announced earlier today that he is working on a plan to have drug price come down by having competition. can you tell us what that plan is going to be, when it might be rolled out? and the second question, the bill also includes a tax break for insurance executives that make more than $500,000. since this is about patients, why is that tax break important? secretary price: for the latter, i'm not aware of that i'll look into that. drug pricing is important. so many individuals are now having significant difficulty being able to afford the medication that they've been
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prescribed. so we -- whether it's -- it's not able tore addressed spefpkly in the -- in this phase one because it's not a revenue or spending issue for the federal government. so it can't be in this phase one. but in phase two and three, which may be concurrent along with this phase one but in phase two an three, we look forward to bringing solutions to solve the remarkable challenge that patients have across this land with the increasing price of drugs. i've got to run. we've got a guy right here who will answer the rest of the questions. thank you so much. god bless you. >> house republicans have introduced their proposal to replace the affordable care act. it would keep two popular provisions of the 2010 health care law, allowing children to stay on their parents' health insurance until age 26. also requiring health insurance companies to cover people with pre-existing conditions. among the major changes to the health care plan, eliminating subsidies for health insurance premiums and replacing them with
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tax credits and getting rid of the individual mandate that every american has health insurance. tomorrow, the house ways and means committee will take up the affordable care act replacement legislation. that committee meets at 10:30 a.m. eastern and you can see it live on our companion network c-span3. now here on c-span the news conference from this morning with the chairman of the house ways and means committee and house energy and commerce committee, announcing the republicans' health care bill. mr. walden: good morning. yesterday, the house energy and commerce committee and the house ways and means committee released the american health care act. it's the budget reconciliation legislation as part of the house republicans' efforts to repeal and replace obamacare. after years of broken promises, we are proud to put forward a plan that represents a better way for patients and for american families.
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